How much rates vary
Facilitymedian $2,951 · 10th to 90th $741 to $12,023Professionalmedian $1,514 · 10th to 90th $741 to $2,818
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $794.33 | Professional | None | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $524.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,981.07 Median $11,748.98 Typical High $26,915.35 | Facility | None | $3,981.07 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,548.82 | $2,570.40 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,230.27 Typical High $1,995.26 | Professional | 54 · Surgery only | $912.01 | $1,230.27 | $1,995.26 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,288.25 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $954.99 | $1,288.25 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $3,548.13 | Facility | None | $1,202.26 | $1,862.09 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,949.84 | $3,090.30 |
Health Partners Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,737.80 | $3,019.95 |
Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,819.70 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $4,466.84 Typical High $10,715.19 | Facility | None | $1,288.25 | $4,466.84 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $5,495.41 | Professional | None | $794.33 | $1,445.44 | $5,495.41 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $2,630.27 | Professional | None | $741.31 | $1,288.25 | $2,630.27 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $14,125.38 Median $26,302.68 Typical High $47,863.01 | Facility | 50 · Both sides | $14,125.38 | $26,302.68 | $47,863.01 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,344.23 Typical High $3,890.45 | Professional | 50 · Both sides | $1,698.24 | $2,344.23 | $3,890.45 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $309.03 Typical High $501.19 | Professional | 55 · Aftercare only | $229.09 | $309.03 | $501.19 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $977.24 Typical High $1,621.81 | Professional | 62 · Two surgeons | $707.95 | $977.24 | $1,621.81 |
Where Minnesota sits
The same service costs 6.2 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $14,513MT $2,350
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.